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This serious and growing health threat is attributed to increasing urbanization of the world's populations with consequent exposure to polluted air. Especially vulnerable are the elderly, patients with pre\u2010existing CVD, and children. The cumulative lifetime burden in children is particularly of concern because their rapidly developing cardiopulmonary systems are more susceptible to damage and they spend more time outdoors and therefore inhale more pollutants. World Health Organization estimates that 93% of the world's children aged &lt;15\u00a0years\u20141.8\u00a0billion children\u2014breathe air that puts their health and development at risk. Here, we present growing scientific evidence, including from our own group, that chronic exposure to air pollution early in life is directly linked to development of major CVD risks, including obesity, hypertension, and metabolic disorders. In this review, we surveyed the literature for current knowledge of how pollution exposure early in life adversely impacts cardiovascular phenotypes, and lay the foundation for early intervention and other strategies that can help prevent this damage. We also discuss the need for better guidelines and additional research to validate exposure metrics and interventions that will ultimately help healthcare providers reduce the growing burden of CVD from pollution.<\/jats:p>","DOI":"10.1161\/jaha.119.014944","type":"journal-article","created":{"date-parts":[[2020,3,15]],"date-time":"2020-03-15T05:10:17Z","timestamp":1584249017000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":117,"title":["Cumulative Lifetime Burden of Cardiovascular Disease From Early Exposure to Air Pollution"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9675-2607","authenticated-orcid":false,"given":"Juyong Brian","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Medicine Stanford University Stanford CA"},{"name":"Stanford Cardiovascular Institute Stanford University Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Prunicki","sequence":"additional","affiliation":[{"name":"Sean N. Parker Center for Allergy and Asthma Research Stanford University Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Haddad","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Medicine Stanford University Stanford CA"},{"name":"Stanford Cardiovascular Institute Stanford University Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Dant","sequence":"additional","affiliation":[{"name":"Sean N. Parker Center for Allergy and Asthma Research Stanford University Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanitha","family":"Sampath","sequence":"additional","affiliation":[{"name":"Sean N. Parker Center for Allergy and Asthma Research Stanford University Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rushali","family":"Patel","sequence":"additional","affiliation":[{"name":"Sean N. 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